NSG 318 Complete Exam Questions & Answers
A student nurse asks what are the used on Tenormin. What should the nurse teach the
student?
It is used to treat HTN, angina and treat acute MI
A doctor orders atenolol for a patient with a history of acute bronchospasms. What action
should the nurse take next?
a. Measure pts BP before administering
b. Give the next dose
c. Obtain a medical reconciliation
d. Question the HCPs order
d. Question the HCPs order. Bronchospasm is a contraindication because atenolol has a slight
chance of stimulating Beta 2
A new grad doctor asks the nurse what are the drug interactions for atenolol. What should
the nurse inform the doctor?
- Atropine and other anticholinergics bc it increases absorption
- NSAIDS decreases the effects
- Insulin and sulfonylureas increase the risk of hypoglycemia
A patient beginning Tenormin would like to know what side effects to look out for. What
should the nurse teach the patient?
Normal side effects are depression, cool extremities and ED. If you have any of the following
side effects you should report it: Dyspnea, bradycardia, excessive dizziness, early morning
insomnia and mental depression.
What patient education needs to given to the patient in regards to atenolol?
- Sit on side of the bed before ambulating to avoid orthostatic hypotension
- Pulse should be >60 BPM prior to administering
- Do NOT stop med abruptly to avoid rebound and risk of MI. It should be weaned off over 1-2
weeks
- Warn male pts of ED which is usually dose-related
- Advise patient to not drive/operate dangerous equipment until drug response is known
Which medication is a calcium channel blocker?
Cardizem (diltiazem)
,What are the uses of diltiazem?
Atrial dysrhythmias, HTN and relaxes coronary and peripheral blood vessels
Hint: Calms heart by lowering BR and BP = zen heart
A student nurse asks what drug interactions are associated with Cardizem. What should the
nurse inform the student?
Digoxin, beta blockers and other antihypertensive
A patient is on antihypertensive therapy. She is interested in CAMs. Which CAMs should the
nurse advise her to avoid? SATA
a. Garlic
b. Psyllium
c. Gingko
d. Green Tea
d. Hawthorn
e. Aloe
Garlic and Hawthorn. Other CAMs with antihypertensive effects includes: Licorice, Goldenseal,
Parsley and Ephedra
A patient states they want to stop taking diltiazem because it is causing peripheral edema.
What should the nurse inform the patient?
Peripheral edema is normal SE. If this medication is abruptly stopped, it can cause acute angina
episode.
A patient on Cardizem starts to have bradycardia and hypotension. What antidote(s) would
the nurse expect the HCP would like to be administered?
Atropine and Calcium Chloride. Atropine reverses the bradycardia because it is an
anticholinergic. Calcium chloride reverses the hypotension
Which medication is in the cardiac glycoside drug class?
a. Nitroglycerin
b. Digoxin
c. Coumadin
d. Plavix
b. Digoxin
What are the uses of Digoxin?
Used to treat heart failure and atrial fibrillation?
,A patient's serum digoxin level is 1.1 ng/mL. What action should the nurse take?
a. Given the next dose
b. Retake the lab test
c. Split the dose in half
d. Inform the HCP
D. The nurse should inform the HCP because this results indicates toxicity.
What is the therapeutic serum level of digoxin?
0.5 - 1 ng/ml
The nurse is caring for a patient on digoxin therapy. The student nurse asks the nurse what
are signs of digoxin toxicity. What should the nurse teach the student nurse?
a. Depression
b. Circulatory Collapse
c. Tachycardia
d. Green or yellow hallos
D. Green or yellow halos, cardiac dysrhythmias, bradycardia, vomiting, anorexia and diarrhea
A patient on digoxin therapy reports having blurred vision and yellow halos and respirations
are 5 per minute. What action should the nurse take next?
a. Administer protamine
b. Administer digoxin immune fab
c. Administer vitamin K
d. Nothing these are normal side effects
B. Administer Digoxin Immune Fab. This med reverses the side effect of bradycardia
Which CAMs increase the risk of digitalis toxicity? SATA
a. Gingko
b. Ginseng
c. Cinnamon
d. Licorice
e. Aloe
f. Parsley
g. Green tea
h. Ephedra
Ginseng, Licorice, Aloe and Ephedra
, A patient on digoxin therapy frequently takes CAMs. Which CAMs should the nurse educate
the patient to avoid?
Ginseng, St. John's Wort, Psyllium, Hawthorn, Licorice, Aloe, and Ephedra
What are 3 important things a nurse needs to watch for during digoxin therapy?
Apical pulse >60
Toxicity: 0.5-1.0 ng/mL
Potassium: Increases risk of digitalis toxicity
Which medication is in the antianginal drug class?
a. Nitroglycerin
b. Digoxin
c. Coumadin
d. Plavix
a. Nitroglycerin
How should a nurse instruct a patient to take nitroglycerin?
The most common route is sublingual.
Take 1 dose when the chest pain begins.
If still having chest pain in 5 mins call 911 and then take a 2nd dose.
If still having chest pain in 5 mins and EMT has not arrived, take a 3 and FINAL dose
A patient asks a nurse why they can only have 3 doses of nitroglycerin. What should the nurse
tell the patient?
The main side effect of this med is that it decreases BP. With each dose the BP is decreasing. So
with multiple doses, you will eventually have no BP.
A patient was prescribed a topical/transdermal nitroglycerin. What should the nurse teach
the patient about this route?
The patient needs to be nitrate free for 8-12 hours to avoid developing a tolerance. Typically,
this nitrate free period can occur at night.
A patient asks the nurse what side effects they should look out for while on nitroglycerin.
What information should the nurse give to the patient?
Blurred vision, palpitation to compensate for the low BP, tolerance, and orthostatic
hypotension. A life-threatening side effect is circulatory collapse which is when there is no BP if
you overdose
What intervention should the nurse take when administering nitroglycerin?
A student nurse asks what are the used on Tenormin. What should the nurse teach the
student?
It is used to treat HTN, angina and treat acute MI
A doctor orders atenolol for a patient with a history of acute bronchospasms. What action
should the nurse take next?
a. Measure pts BP before administering
b. Give the next dose
c. Obtain a medical reconciliation
d. Question the HCPs order
d. Question the HCPs order. Bronchospasm is a contraindication because atenolol has a slight
chance of stimulating Beta 2
A new grad doctor asks the nurse what are the drug interactions for atenolol. What should
the nurse inform the doctor?
- Atropine and other anticholinergics bc it increases absorption
- NSAIDS decreases the effects
- Insulin and sulfonylureas increase the risk of hypoglycemia
A patient beginning Tenormin would like to know what side effects to look out for. What
should the nurse teach the patient?
Normal side effects are depression, cool extremities and ED. If you have any of the following
side effects you should report it: Dyspnea, bradycardia, excessive dizziness, early morning
insomnia and mental depression.
What patient education needs to given to the patient in regards to atenolol?
- Sit on side of the bed before ambulating to avoid orthostatic hypotension
- Pulse should be >60 BPM prior to administering
- Do NOT stop med abruptly to avoid rebound and risk of MI. It should be weaned off over 1-2
weeks
- Warn male pts of ED which is usually dose-related
- Advise patient to not drive/operate dangerous equipment until drug response is known
Which medication is a calcium channel blocker?
Cardizem (diltiazem)
,What are the uses of diltiazem?
Atrial dysrhythmias, HTN and relaxes coronary and peripheral blood vessels
Hint: Calms heart by lowering BR and BP = zen heart
A student nurse asks what drug interactions are associated with Cardizem. What should the
nurse inform the student?
Digoxin, beta blockers and other antihypertensive
A patient is on antihypertensive therapy. She is interested in CAMs. Which CAMs should the
nurse advise her to avoid? SATA
a. Garlic
b. Psyllium
c. Gingko
d. Green Tea
d. Hawthorn
e. Aloe
Garlic and Hawthorn. Other CAMs with antihypertensive effects includes: Licorice, Goldenseal,
Parsley and Ephedra
A patient states they want to stop taking diltiazem because it is causing peripheral edema.
What should the nurse inform the patient?
Peripheral edema is normal SE. If this medication is abruptly stopped, it can cause acute angina
episode.
A patient on Cardizem starts to have bradycardia and hypotension. What antidote(s) would
the nurse expect the HCP would like to be administered?
Atropine and Calcium Chloride. Atropine reverses the bradycardia because it is an
anticholinergic. Calcium chloride reverses the hypotension
Which medication is in the cardiac glycoside drug class?
a. Nitroglycerin
b. Digoxin
c. Coumadin
d. Plavix
b. Digoxin
What are the uses of Digoxin?
Used to treat heart failure and atrial fibrillation?
,A patient's serum digoxin level is 1.1 ng/mL. What action should the nurse take?
a. Given the next dose
b. Retake the lab test
c. Split the dose in half
d. Inform the HCP
D. The nurse should inform the HCP because this results indicates toxicity.
What is the therapeutic serum level of digoxin?
0.5 - 1 ng/ml
The nurse is caring for a patient on digoxin therapy. The student nurse asks the nurse what
are signs of digoxin toxicity. What should the nurse teach the student nurse?
a. Depression
b. Circulatory Collapse
c. Tachycardia
d. Green or yellow hallos
D. Green or yellow halos, cardiac dysrhythmias, bradycardia, vomiting, anorexia and diarrhea
A patient on digoxin therapy reports having blurred vision and yellow halos and respirations
are 5 per minute. What action should the nurse take next?
a. Administer protamine
b. Administer digoxin immune fab
c. Administer vitamin K
d. Nothing these are normal side effects
B. Administer Digoxin Immune Fab. This med reverses the side effect of bradycardia
Which CAMs increase the risk of digitalis toxicity? SATA
a. Gingko
b. Ginseng
c. Cinnamon
d. Licorice
e. Aloe
f. Parsley
g. Green tea
h. Ephedra
Ginseng, Licorice, Aloe and Ephedra
, A patient on digoxin therapy frequently takes CAMs. Which CAMs should the nurse educate
the patient to avoid?
Ginseng, St. John's Wort, Psyllium, Hawthorn, Licorice, Aloe, and Ephedra
What are 3 important things a nurse needs to watch for during digoxin therapy?
Apical pulse >60
Toxicity: 0.5-1.0 ng/mL
Potassium: Increases risk of digitalis toxicity
Which medication is in the antianginal drug class?
a. Nitroglycerin
b. Digoxin
c. Coumadin
d. Plavix
a. Nitroglycerin
How should a nurse instruct a patient to take nitroglycerin?
The most common route is sublingual.
Take 1 dose when the chest pain begins.
If still having chest pain in 5 mins call 911 and then take a 2nd dose.
If still having chest pain in 5 mins and EMT has not arrived, take a 3 and FINAL dose
A patient asks a nurse why they can only have 3 doses of nitroglycerin. What should the nurse
tell the patient?
The main side effect of this med is that it decreases BP. With each dose the BP is decreasing. So
with multiple doses, you will eventually have no BP.
A patient was prescribed a topical/transdermal nitroglycerin. What should the nurse teach
the patient about this route?
The patient needs to be nitrate free for 8-12 hours to avoid developing a tolerance. Typically,
this nitrate free period can occur at night.
A patient asks the nurse what side effects they should look out for while on nitroglycerin.
What information should the nurse give to the patient?
Blurred vision, palpitation to compensate for the low BP, tolerance, and orthostatic
hypotension. A life-threatening side effect is circulatory collapse which is when there is no BP if
you overdose
What intervention should the nurse take when administering nitroglycerin?
